ABSTRACT
To examine the sensitivity of the chloride/phosphate [Cl/PO[4]] ratio with a cut-off point of >33 as a diagnostic test for primary hyperparathyroidism [pHPT] in surgically proven patients, and its performance at different calcium levels. This is a retrospective medical records based study. Data of 120 patients diagnosed with pHPT, already operated in the Department of Surgery, Cisanello Hospital, Pisa, Italy between March 2010 and June 2011 were reviewed. They were divided into 4 subgroups according to their calcium levels. The Cl/PO[4] ratio was measured for each patient, with a cut-off point of 33, sensitivity of Cl/PO[4] test was measured. Test sensitivity was calculated for each subgroup, and a correlation with the parathyroid hormone [PTH] level was investigated. Performance of the equation was tested for the normocalcemic patients with a suitable control group. The sensitivity of Cl/PO[4] ratio for the whole group was 0.883 [0.809-0.932]. The sensitivity was 0.9340 [0.857-0.973] for patients with serum calcium above normal levels. A similar result of 0.933 [0.830-0.978] was demonstrated for the subgroup with hypercalcemia <1 [mg/dL] above normal level. Normocalcemic patients constituted 24%; for this subgroup, the sensitivity test was 0.724 [0.562-0.887], specificity was 0.763 [0.628-0.898], positive predictive value was 0.700 [0.536-0.864], and negative predictive value was 0.784 [0.651-0.916]. No correlation was identified between the performance of formula and serum PTH level. The Cl/PO[4] test seems to be a good tool to anticipate pHPT and showed a fair performance in normocalcemic patients
ABSTRACT
The definition, rarity, and natural history of Hurthel Cell Cancer [HCC] is not well understood, which makes the diagnosis and management of this cancer a controversial issue. The objective of this study is to report a series of patients with HCC and to discuss the clinical behavior along with the prognostic indicators of this disease in an attempt to make more accurate suggestions for treatment. We conducted a retrospective study reporting on all patients with HCC observed at Jordan University Hospital [JUH] and King Abdullah University Hospital [KAUH], during the period from January 2001 to December 2008. Data were collected, analyzed and compared with different results published in the literature. There were 56 Patients with Hurthle Cell Tumor [HCT], diagnosed on fine needle aspiration, of those; 16 were diagnosed as hurthle cell carcinoma by histopathology. All patients with HCC were treated by total thyroidectomy. Postoperatively, all patients with HCC ware treated with radioactive idodine except for 3 patients. Follow-up period for all patients with HCC ranged from 6 to 84 months. No recurrence or distant metastasis were documented during the study period. We could not find higher incidence of local recurrence, distant metastatis or mortality rates compared to literature. HCC seems to have favorable outcome in our part of the world when treated with total thyroidectomy